tbuckley/cabot-search huggingface dataset:
Delivery of cancer care via an outpatient telephone support line: A cross-sectional study of oncology nursing perspectives on quality and challenges.
Authors: Hely Shah, Lisa Vandermeer, Fiona MacDonald, Gail Laroque, Shannon Nelson, Mark J. Clemons, Sharon McGee
Journal: Journal of Clinical Oncology (2022)

427 Background: Patient support lines (PSLs) help in triaging clinical problems, addressing patient queries and assist in navigating a complex multi-disciplinary oncology team. While providing support and training to nursing staff who operate these lines is key, there is limited data on their experience and feedback to guide this. Our objective was to identify areas of quality improvement for The Ottawa Hospital Cancer Centre (TOHCC) patient support lines. Methods: We conducted a cross-sectional study of oncology nurses’ (ONs’) perspectives on the provision of care via PSLs at a tertiary referral cancer center via an anonymous, descriptive survey. Measures collected included nursing/patient characteristics, nature of questions addressed by the PSL, patient/nursing satisfaction with the service, common challenges faced, and initiatives to improve the patient and nursing experience. Results: Seventy-one percent (30/42) of eligible nurses responded to the survey. The most common disease site, stage, issue, and symptom addressed were breast cancer, metastatic disease, treatment-related toxicity, and pain, respectively. Despite majority of nurses reporting personal and patient satisfaction with the care provided by the PSL, there was variance in the perceived appropriate use of PSL by physicians and patients. As such, fifty-nine percent (17/29) of nurses recommended redefining the responsibilities of the PSL to achieve its maximal potential, with 75% (6/8) ONs identifying high call volumes due to inappropriate questions as a barrier to care. Sixty percent (18/30) of nurses reported that having TOHCC-specific management plans for common issues would improve their experience, and the quality of care provided on PSL. Lastly, 80% (24/30) of nurses denied experiencing a reduction in PSL call volumes with increased patient access to their electronic medical record. Conclusions: Our study identified several important areas for improvement warranting further investigation, despite high reported rates of satisfaction with care provided on PSL. A need for TOHCC standardized management algorithms for common issues addressed on the PSL as well as increased physician and patient education to redefine goals of the PSL to address problems with high volume, and inappropriate calls was identified.
Building a SW program in a private hem/onc practice: Using the PHQ-9 as a starting point.
Authors: Neshama L Marcus, Shannon Woerner, Jake Canavan, Kanokrose Rattanaudom, John Papandrea, Ellen A. Ronnen
Journal: Journal of Clinical Oncology (2022)

266 Background: Hematology/oncology patients historically have high need for social work support. Community practices lack the structure and financial support of hospital practices, often hindering the growth of social work programs. PHQ-9 is a 9-question multipurpose tool for depression screening, diagnosing, monitoring and intervening. This project assessed using the PHQ-9 as a central focus to build a SW program: staff education, EHR automaticity improvement, and enhancement of patient navigation to improve PHQ-9 compliance and patient interventions. Methods: In a multi-office Hem/Onc practice, patients complete the PHQ-9 self-assessment tool, data is entered by MAs, and MD completes an action item according to score. Interventions, which began 1/1/22, included having patients complete the PHQ-9 via a PRO application before visit, interfacing of PRO application with EHR (MA adds score to treatment plan), educating MAs importance of mental health monitoring in health care setting, generating new workflow for MA to send EHR message to SW and notify MD if high score obtained, rapid cycle review of data with MDs, and building out of SW department to accept referrals. Our primary endpoint was % of PHQ-9s completed of those scheduled (every six months). Secondary endpoint was total number of patients internally referred for SW services since 4/1/22 (when psychotherapy services became available). Results: From 7/1/21-12/31/21 (before implementation), of 22,492 visits, 72% had a PHQ-9 reported (with no ongoing monitoring or intervention). From 1/1/22-5/31/22, 88% of 18,655 visits had a PHQ-9 reported. 1,114 patients had a score of 10 or greater on the PHQ-9 between 1/1/22-5/31/22, and of those patients, 100% were assessed for social work intervention. 724 patients were offered referral for mental health services externally; 390 patients have been recommended for internal SW referral (72 have registered for psychotherapy to begin 7/1/22). Conclusions: Our results illustrate the ability to achieve engagement of a SW program in a private practice setting over a limited time by using the PHQ-9 as a primary focus. Education of all staff involved in the process is paramount and will be emphasized when rolling out future components of the SW program: support groups, educational lecture series, and other concrete services.
Communication with caregivers about tumor genomic sequencing in childhood cancers.
Authors: Brittany M. Lee, Emily Bonkowski, Jonathan M Marron, Krysta S. Barton, Abby R. Rosenberg
Journal: Journal of Clinical Oncology (2022)

245 Background: Advances in genomic testing have the potential to improve the diagnosis, risk stratification, and targeted treatment of childhood cancers, and tumor genomic sequencing (TGS) at diagnosis is becoming standard of care. Nevertheless, little is known about how best to communicate information about the process and intent of TGS to patients and their caregivers, nor about discussion of TGS results and their implications. This demonstrates a glaring need, particularly given the already distressing time of a new diagnosis. Methods: This qualitative study included English-speaking caregivers (&gt; 18yo) of children (&lt; 18yo) with cancer (diagnosed 2mo-3yr prior), who had TGS sent at diagnosis. Caregivers completed a short demographic survey, and we extracted child medical data from the electronic health record. We conducted semi-structured, one-on-one interviews with participants about their experiences with and recommendations for communication about TGS at diagnosis. We transcribed the interviews verbatim and used Dedoose qualitative software to code the transcripts. We employed a conventional content approach for codebook development and used inductive coding, followed by deeper thematic analyses. Results: A total of 12 caregivers enrolled. Their median age was 39 years (range 32 – 52) and most were white (11, 92%), female (9, 75%), and had at least a bachelor’s degree (8, 67%). Their children had leukemia (8, 67%), neuroblastoma (2, 17%), or brain tumors (2, 17%). Ten (83%) of the children had somatic findings on TGS, 3 (25%) of which prompted the recommendation for germline testing. On average, interviews lasted 36 minutes (19-46). We found two information-delivery themes, both of which underscored existing communication recommendations in pediatric oncology. (1) Caregivers experience informational and emotional overload at the time of their child’s cancer diagnosis. The intensity of emotions negatively impacts information processing, and comprehension of information generally occurs best over time. Some parents described managing their emotions through eliciting more information. (2) Caregivers recommended a systematic delivery of information about TGS. Many preferred concise, direct information about TGS upfront, along with written information and opportunities to request more information over time. Some caregivers specifically cited the value of receiving information that would allow them to be “mentally prepared,” such as hearing about the potential for unexpected findings. Conclusions: Caregivers’ preferences for communication about TGS at diagnosis fit within established communication practices in pediatric oncology. Given both the complexity and potential psychosocial impacts of TGS, particular attention to systematic, standardized but tailorable information delivery to caregivers about TGS is warranted.
MBD5 and MBD6 stabilize the BAP1 complex and promote BAP1-dependent cancer
Authors: Natsumi Tsuboyama, Aileen Patricia Szczepanski, Zibo Zhao, Lu Wang
Journal: Genome biology (2022)

Abstract Background BRCA1-associated protein 1 (BAP1) is an ubiquitin carboxy-terminal hydrolase, which forms a multi-protein complex with different epigenetic factors, such as ASXL1-3 and FOXK1/2. At the chromatin level, BAP1 catalyzes the removal of mono-ubiquitination on histone H2AK119 in collaboration with other subunits within the complex and functions as a transcriptional activator in mammalian cells. However, the crosstalk between different subunits and how these subunits impact BAP1’s function remains unclear. Results We report the identification of the methyl-CpG-binding domain proteins 5 and 6 (MBD5 and MBD6) that bind to the C-terminal PHD fingers of the large scaffold subunits ASXL1-3 and stabilize the BAP1 complex at the chromatin. We further identify a novel Drosophila protein, the six-banded (SBA), as an ortholog of human MBD5 and MBD6, and demonstrate that the core modules of the BAP1 complex is structurally and functionally conserved from Drosophila (Calypso/ASX/SBA) to human cells (BAP1/ASXL/MBD). Dysfunction of the BAP1 complex induced by the misregulation/mutations in its subunit(s) are frequent in many human cancers. In BAP1-dependent human cancers, such as small cell lung cancer (SCLC), MBD6 tends to be a part of the predominant complex formed. Therefore, depletion of MBD6 leads to a global loss of BAP1 occupancy at the chromatin, resulting in a reduction of BAP1-dependent gene expression and tumor growth in vitro and in vivo. Conclusions We characterize MBD5 and MBD6 as important regulators of the BAP1 complex and maintain its transcriptional landscape, shedding light on the therapeutic potential of targeting MBD5 and MBD6 in BAP1-dependent human cancers.
Serine metabolism orchestrates macrophage polarization by regulating the IGF1–p38 axis
Authors: Xiao Shan, Penghui Hu, Lina Ni, Long Shen, Yanan Zhang, Zemin Ji, Yan Cui, Meihua Guo, Haoan Wang, Liyuan Ran, Kun Yang, Ting Wang, Lei Wang, Bin Chen, Zhi Yao, Yingjie Wu, Qiujing Yu
Journal: Cellular and Molecular Immunology (2022)
T-lymphoid progenitor-based immunotherapies: clinical perspectives for one and all
Authors: P. Gaudeaux, R. D. Moirangthem, J. Paillet, M. Martin-Corredera, H. Sadek, P. Rault, A. Joshi, J. Zuber, T. S. Soheili, O. Negre, I. André
Journal: Cellular and Molecular Immunology (2022)
RFLP markers show genetic recombination in Botryotinia fuckeliana (Botrytis cinerea) and transposable elements reveal two sympatric species
Authors: T. Giraud, D. Fortini, C. Levis, P. Leroux, Y. Brygoo
Journal: Molecular Biology and Evolution (1997)

Molecular markers revealed that Botryotinia fuckeliana (the teleomorph of Botrytis cinerea), a haploid, filamentous, heterothallic ascomycete, contained a large amount of intrapopulation genetic variation. The markers were used to determine the mode of reproduction and the population structure of this fungus. We did not detect any differentiation between isolates from different organs, collection dates, varieties of grape, or locations in the Champagne region of France, but two unexpected sympatric populations were identified. One group of isolates (transposa) contained the transposable elements Boty and Flipper; the other (vacuma) did not. These groups differed from one another for all the other markers. RFLP markers showed that there was genetic recombination in both groups of isolates. We conclude that there are two sympatric populations of B. fuckeliana in Champagne. One species (transposa) seems to be local and well adapted, while the other one (vacuma) is presumably a heterogeneous migrant population.
Novel inhaled antifungal for pseudomembranous<i>Aspergillus</i>tracheobronchitis complicating connective tissue disease
Authors: Shivani Singh, Luke S P Moore, Nabeela Mughal, Matthew Ho, Darius Armstrong-James, Suveer Singh
Journal: Thorax (2022)

<h3>Introduction</h3> It has been estimated that over one-third of all Americans die from diseases that are, in part, brought on by behaviors that compromise their health. Mokdad, Mark, Stroup &amp; Gerberding (2000) recently reported that tobacco, poor diet, and physical inactivity were the three leading behaviorally related causes of death in the United States. It is well understood that many of these health-compromising behaviors begin in adolescence. As a result, promoting healthy lifestyles has become a national priority and is an integral component of the recommendations outlined in Healthy People 2010. Understanding why people engage in behaviors that are harmful to their health and what protective factors discourage engagement in health-compromising behaviors is the first step in developing effective intervention, education, and prevention programs. One construct that has shown predictive value with regard to health-compromising behaviors is self-efficacy. <h3>Method</h3> Data analyzed for this project are part of a larger data set collected during "Goals for Health, " a longitudinal study funded by the National Cancer Institute. This study examined self-report data collected from 938 rural adolescents in the eighth grade (54% Caucasian and 46% African American) to determine the roles of tobacco and nutritional self-efficacy as predictors of tobacco use, exercise behavior, and dietary fat intake. In addition, this study examined the roles of sex, race, and geographic region as moderating the relationships between self-efficacy and these health-compromising behaviors. <h3>Results</h3> Tobacco and nutritional self-efficacy were identified as significant predictors of these health-compromising behaviors. These results indicate that self-efficacy may not be a domain specific as previous research has indicated. For example, results indicate that tobacco self-efficacy predicted not only tobacco use behavior but dietary fat consumption as well. The results of this study indicate that self-efficacy may have less domain specificity when predicting behaviors that are related (eg, health behaviors). Results also indicate that sex, race, and geographic region affect the involvement in and maintenance of these health-compromising behaviors and moderate the relationship between self-efficacy and these behaviors. For example, tobacco self-efficacy was identified as a stronger predictor of tobacco use behavior for boys than it was for girls. The results of this study suggest that prevention programming should be designed with these demographic variables in mind to ensure the program9s success.
Patterns of olanzapine prescribing for those receiving highly emetogenic chemotherapy.
Authors: Daniel S Childs, David A Helfinstine, Lindsey R. Sangaralingham, Jacob Orme, Ciara Catherine O'Sullivan, Charles L. Loprinzi, Kathryn Jean Ruddy
Journal: Journal of Clinical Oncology (2022)

232 Background: Olanzapine has an important role in preventing and treating nausea and vomiting from highly emetogenic chemotherapy (HEC). This drug, for the last 5 years, has been a component of most major antiemesis guidelines. The aim of the current study was to assess how often olanzapine has been prescribed for patients receiving HEC. Methods: A retrospective analysis was performed using an OptumLabs de-identified clinical database of medical and pharmacy claims. The database was filtered for patients starting HEC in the interval of 2006 to Q2 of 2021. Descriptive statistics were used to analyze patient characteristics and year-by-year antiemetic prescribing patterns, coinciding with cycles 1 and 2 of chemotherapy. Results: A total of 63,154 distinct patients were included. The median age was 58 years (range, 18-88). Over a quarter of the patients identified as Black, Hispanic, Asian, or other. Breast (45.2%) and hematologic (20.8%) cancers were the most common diagnoses. In 2016, olanzapine was prescribed to only 1.4% of patients with cycle 1 of HEC. Prescriptions increased modestly each year, and by 2021, 13.9% of patients received olanzapine with their first cycle of chemotherapy. An additional 5.7% of patients received olanzapine for breakthrough symptoms or enhanced prophylaxis during cycle 2. In 2021, over three-quarters of patients were prescribed antiemetics in a guideline concordant manner, with either an olanzapine-containing quadruplet (12.2%), an NK1 receptor antagonist triplet (64.5%), or an olanzapine triplet (exact number suppressed due to small sample size). Conclusions: The rate of olanzapine prescribing is less than might be expected following its inclusion in major antiemesis guidelines. This finding highlights the challenges of disseminating information and keeping prescribing systems updated with the newest evidence in supportive oncology.
Sociodemographic difference in patients who enroll and decline remote symptom monitoring (RSM).
Authors: Keyonsis Hildreth, Nicole E. Caston, D'Ambra Dent, Stacey A. Ingram, Fallon Lalor, Jeffrey Franks, Andres Azuero, Jennifer Young Pierce, Chelsea L. McGowen, Courtney J. Andrews, Chao-Hui Huang, James Nicholas Dionne-Odom, Bryan J Weiner, Bradford E. Jackson, Ethan Basch, Angela M. Stover, Doris Howell, Gabrielle Betty Rocque
Journal: Journal of Clinical Oncology (2022)

268 Background: Remote symptom monitoring (RSM) using patient-reported outcomes has been shown to reduce symptom burden and hospitalizations in clinical trials. However, little is known about how willing patients are to participate in remote symptom monitoring in real-world settings, particularly for vulnerable patient populations. This study aims to compare characteristics of cancer patients enrolled vs. patients who declined enrollment into RSM. Methods: This prospective study used data that assessed the characteristics of patients who enrolled vs. patients who declined enrollment into RSM. Inclusion criteria included participants’ age ≥18 with cancer who received chemotherapy, targeted therapy, or immunotherapy at the University of Alabama at Birmingham. Race and ethnicity (Black or African American, White, Asian, other and unknown), sex, cancer type (breast, gastrointestinal [GI], genitourinary [GU], gynecological [GYNX], head and neck, leukemia, lymphoma, melanoma, myeloma and other), urban/rural residence, Area Deprivation Index (ADI), and insurance type (Medicaid, Medicare, none, other and private) were abstracted from electronic medical records (EMR) and PRO platform (Carevive). Descriptive statistics were calculated using frequencies and percentages for categorical variables and medians and interquartile ranges for continuous variables. Differences in enrollment status characteristics were calculated using measures of effect size such as Cramer’s V. Results: Of the 307 patients, two thirds of patients were female (71%); 25% were Black or African American and 66% were White patients; 15% lived in an area of higher disadvantage. For insurance, 46%, 26%, 10%, 8%, and 9% of patients had Private, Medicare, Medicaid, other insurance, and no insurance, respectively. The proportion of patients who declined enrollment was higher for males than females (22% vs. 10%), Black or African American than White (18% vs 13%); and having Medicare than private insurance (22% vs. 10%). Compared to those who enrolled, patients who declined enrollment were more often to be male (V:0.2), Black or African American (V:0.1); and have Medicare insurance (V:0.2). Patients enrolled vs. declined in RSM had similar ADI scores (V:0.01). Conclusions: This study demonstrates that potentially vulnerable patients, including Black patients and those with public insurance, have lower RSM engagement. Future analysis is needed to understand participation barriers and how to better engage diverse populations to ensure optimal healthcare delivery to all patients.
Severe symptom reporting in medical oncology patients at community cancer centers assessed through eSyM.
Authors: Jessica J Bian, Christine Cronin, Angela Tramontano, Deborah Schrag, Raymond U. Osarogiagbon, Don S. Dizon, Sandra L. Wong, Hannah W. Hazard-Jenkins, Michael J. Hassett
Journal: Journal of Clinical Oncology (2022)

242 Background: Among cancer patients (pts) treated with chemotherapy, electronic patient reported outcome (ePRO)-based symptom management programs at quaternary cancer care institutions have improved outcomes. Uptake of ePRO programs in the real-world setting, where less is known about severe symptom reporting, is often complicated by perceptions of increased workload and erroneous severe symptom reporting. The SIMPRO study group, which includes 6 diverse health systems, are implementing an integrated electronic symptom management (eSyM) program to address these challenges. Methods: SIMPRO sites deployed the Epic-embedded eSyM program for thoracic (THOR), gastrointestinal (GI), and gynecologic (GYN) medical oncology (MO) pts, who received PRO-CTCAE-based questionnaires via the patient portal twice weekly for 6 months after starting a new chemotherapy regimen. Symptoms were scored 0 (none), 1 (mild), 2 (moderate), and 3 (severe) and automatically transmitted to care teams within Epic. The distribution and predictors of severe symptom reporting were assessed using descriptive statistics and logistic regression modeling. Results: From September 2019 – March 2022, 47% of eligible pts (2679/5716) submitted 27,062 questionnaires (median age of 67 years, 55% female, 78% white, 53% married, and 49% retired). 17% of eSyM questionnaires included at least 1 severe symptom (15% for GI, 14% for GYN, and 18% for THOR). Table displays the frequencies of all symptoms reported with fatigue, general pain, and constipation being most common. Among respondents, older, black, and employed pts reported significantly fewer severe symptoms (p &lt; 0.03); cancer type was not associated with a greater likelihood of severe symptom reporting. Conclusions: Only approximately 1 of every 6 eSyM responses included a severe symptom, suggesting that routine monitoring in the real-world could help identify patients experiencing bothersome symptoms with minimal disruption to clinical workload. The mix of symptoms commonly reported as severe are challenging to treat with medications alone, arguing that symptom management strategies should provide multidisciplinary supportive care. Interventions that aide both patients and care teams and are embedded within eSyM or Epic could help address these symptoms without overburdening care teams. Clinical trial information: NCT03850912. [Table: see text]